OBJECTIVE:To discuss the influence of Shanghai Guiding Principles of Clinical Use of Antibiotics Implementing Rules(Trial)(named Implementing Rules for short) on prophylactic use of drugs in patients underwent general surgery operation.METHODS:In retrospective study,inpatients of general surgery department in our hospital from Sep.2006 to Feb.2008 were divided into 3 groups(Group 1:6 months before Implementing Rules issued;Group 2:0～6 months after Implementing Rules issued;Group 3:7～12 months after Implementing Rules issued).The utilization of antibiotics was analyzed as well as its rationality.RESULTS:A total of 1 308 cases were enrolled.The utilization frequency of antibiotics was 3 463.Less than half of cases met the indication of antibiotics while the rate of drug sensitivity test was 1.2%.The treatment courses of 3 groups were(3.4?4.3) d,(3.3?2.9) d and(3.1?3.0) d.The proportions of rational drug use were 36.5%,35.1% and 40.7%.But the selection of antibiotics,drug combination and ADR report were not significantly improved.CONCLUSION:The issue of Implementing Rules has promoted the rational use of antibiotics in general surgery department.Further training and monitoring are needed.

Objective To observe the evaluation value of serum high mobility group protein B1(HMGB-1) and APACHE Ⅱ score in severity degree and prognosis of the patients with acute pancreatitis(AP).Methods Sixty patients with AP were collected,including 20 cases in the mild AP group(MAP),20 cases in moderate AP group(MSAP) and 20 cases in the severe AP group (SAP).The HMGB-1 level in each group was dynamically monitored on 1,3,7 d after admission and its relationship with AP severity and APACHE Ⅱ score was analyzed.According to clinical outcomes,these cases were divided into the survival group(48 cases) and death group(12 cases),and the value of serum HMGB-1 level and APACHE-Ⅱ scores for evaluating the prognosis was analyzed.Results The HMGB-1 values on 1,3,7 d in the MAP group were(2.16±0.35),(4.34±0.96),(1.21±0.33)μg/L respectively,which in the MSAP group were(7.78 ±1.32),(10.45 ± 2.36),(6.92 ± 1.55) μg/L respectively,and which in the SAP group were(14.12±2.64),(27.53±8.19),(11.34± 2.57)μg/L respectively.The HMGB-1 levels in the SAP group were significantly higher than those in the MAP group and MSAP group,the differences were statistically significant (P＜ 0.01,P＜ 0.05);the HMGB-1 level had statistical difference between the MSAP group and MAP group(P＜0.05);the HMGB1l score on 3 d in the SAP group was increased with△3-1 HMGB1 increas(difference value of HMGB1 on 1,3 d),the both showed the positive correlation(r=0.725,P＜0.05).But the APACHE-Ⅱ score in the MSAP and MAP groups had no obvious change with the HMGB-1 level increase,the difference was not statistically significant(r=0.127,0.114,P＞0.05).Serum HMGB1 level and APACHE-lⅡ score in the death group were significantly higher than those in the survival group(P＜0.05).Conclusion The serum HMGB1 level has good correlation with APACHE-Ⅱ score in AP;their combination can serve the sensitive indicator for predicting disease condition severity and prognosis of AP.

Objective To investigate the relationship between familial hemiplegic migraine (FHM ) with the mutation of CACNA1A gene .Methods Total genomic DNA of a family affected members and 1 000 normal controls was extracted for conduc‐ting the CACNA1A gene sequencing research and the bioinformatics analysis .Results The novel mutation site c .1168A>G of ex‐on located in CACNA1A gene led to Asn to be replaced with Asp (N390D) .Conclusion The mutation(N390D) of CACNA1A gene is a newly found novel pathogenic mutation lead to familial hemiplegic migraine .

Objective To investigate the correlation between cytochrome P450(CYP) 2C19 gene polymorphism with major adverse cardiovascular events(MACE) after PCI in the patients with coronary heart disease(CHD).Methods A total of 233 patients with CHD undergoing PCI in the cardiology department of our hospital from January 2014 to January 2015 were selected.All patients were given the standardized dual anti-platelet therapy of aspirin and clopidogrel.The occurrence situation of MACE within 1 year(unstable angina pectoris,cardiac death,in-stent restenosis,non-fatal myocardial infarction) was obtained by follow up.All patients were divided into the MACE group and non-MACE group.The PCR solubility curve was adopted to detect the CYP2C19 gene polymorphism.Results Among 233 cases of CHD,37 cases (15.88％) developed cardiovascular events and 196 cases (84.12 ％) did not develop vascular events;the age,sex,hypertension and diabetes mellitus had no statistical differences between the two groups(P＞0.05).The frequency of CYP2C19 * 1 in the included cases was 68.45％,which of CYP2C19 * 2 was 28.33％ and which of CYP2C19 * 3 was 3.22％.The extensive-metabolism,intermediate metabolism and slow metabolism types in the cardiovascular events group accounted for 5.41 ％,64.86 ％ and 29.73 ％ respectively,while which in the non event group were 59.69 ％,29.08％ and 11.22％ respectively,the CYP2C19 genotype distribution had statistically significant difference between the two groups(P＜0.05).The multivariate Logistic regression analysis showed that CYP2C19 intermediate metabolism type [OR 2.562,95％CI(2.825,7.350),P=0.021 0],slow metabolism type [OR 5.139,95％CI(1.289,5.232),P＜0.01],hypertension [OR 2.480,95 ％CI(1.079,5.698),P=0.032 4],smoking[OR 4.802,95％CI(1.082,18.371),P=0.029 0] were the independent risk factors for the occurrence of cardiovascular events in the patients with CHD.Conclusion CYP2C19 * 2 and CYP2C19 * 3 gene polymorphism are the independent risk factors for MACE occurrence after PCI in the patients with CHD.

Objective To identify mutations of CACNA1A gene in a family with hemiplegic migraine.Methods Total genomic DNA was extracted from a family with 3 affected members and 1 000 healthy controls.The proband and his patient sister were subjected to exome sequencing.Ten family members including 3 patients were subjected to linkage analysis.The coding exons of the CACNA1A gene were amplified and sequenced in affected and normal individuals. Bioinformatics analysis were performed.Results A novel CACNA1A mutation was identified in the 3 patients.The nonsense mutation of A to G was detected at nucleotide 1168 ( c.1168A >G) which converted the Asn codon ( AAT) to Asp (GAT) in exon 8.Conclusion The mutation(N390D) detected in the present study is considered to result in the Chinese Hemiplegic migraine family.

OBJECTIVE To establish multiple PCR(M-PCR) assay for simultaneous detection of Treponema pallidum(TP) and herpes simplex virus(HSV),Haemophilus ducreyi(HD).METHODS According to specific gene sequence of the three agents:HSV DNA polymerse gene,TP tpp47 gene,HD 6s rRNA gene;three sets of specific primers were designed and a multiple PCR assay was developed to detect 3 agents in one test.RESULTS The target DNA of 3 agents were specifically amplified by their specific primers,the appropriate size of four DNA fragments was 202bp,252bp,152bp for TP,HSV and HD,respectively.The DNA of other several common microbes of genital tract and human genome could not be amplified by three sets of primers.CONCLUSIONS Primary study indicated that the M-PCR assay can simultaneously,specifically and rapidly detect out HSV,TP and HD.

Objective To find out households consumption of iodized salt in Xinjian county, and to provide scientific basis for prevention and treatment of iodine deficiency disorders(IDD). Methods From 2006 - 2010 in Jiangxi province, according to the direction of east, west, south, and north, nine townships(streets) were selected,in each township (street), 4 administrative villages (committees) were selected, in each administrative village(committee) 8 households were selected to collect their edible salt each year, direct titration method was adopted to detect salt iodine. Results From 2006 - 2010 a total of 1440 salt samples were collected, of which 1379 were qualified iodized salt, 34 unqualified, 27 non-iodized salt; iodized salt coverage rate, qualified iodized salt and iodized salt consumption rates were 98.13% (1413/1440), 97.59% (1379/1413) and 95.76% (1379/1440),respectively, and the rate of non-iodized salt was 1.88% (27/1440). Conclusions The intake rate of qualified iodized salt in Xinjian county have reached the standards of eliminating IDD. The quality of iodized salt should be improved in few counties. In the future, we should also increase the use of various forms advocacy of IDD prevention and treatment, and educate the masses to enhance self-protection awareness, so that they can consciously resist the salt smuggling, and refuse to buy non-iodized salt.

Objective To observe the effect of rhubarb enema on serum level of high mobility group protein B1 (HMGB1) in patients with severe acute pancreatitis (SAP).Methods A total of 60 cases of patients with SAP in our hospital were collected from October 2014 to October 2016,and were randomly divided into the observation group and control group (30 cases in each group).Serum levels of HMGB1 were dynamically detected on the 1st,3rd and 5th day after admission.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was conducted.The recovery time of gastrointestinal function and time for continuous renal replacement therapy (CRRT) were observed.Results On the 1st day after admission,no statistically significant difference was found in serum level of HMGB1 between the two groups (P＞0.05).The serum level of HMGB1 in the observation group was obviously decreased on the 5th day after admission,which was lower than that in the control group,there was statistically significant difference(P＜0.05).In the observation group,the value of difference between serum level of HMGB1 on the 1st day after admission and that on the 3rd day after admission was significantly negatively related with the APACHE Ⅱ score on the 3rd day after admission(r=-0.604,P＜0.05).In the observation group,the remission time of abdominal pain and abdominal distension,first time of exhaust and defecation and time for CRRT were significantly shorter than those in the control group,there were statistically significant differences (P＜0.05).Conclusion Rhubarb could improvesymptoms and prognosis of patients with SAP through effectively inhibit the expression of HMGB1.

We investigated the distribution characteristics of Yersinia enterocolitica in Ningxia ,China .In accordance with the requirements of the National Yersinia enterocolitica Disease Monitoring Scheme ,Y .enterocolitica were isolated from differ‐ent kinds of specimens collected in Ningxia in 2008 to 2013 .Then they were serotyped and detected for virulence gene and ana‐lyzed the pulsed‐field gel electrophoresis (PFGE) in Chinese CDC .It was found that 173 strains were isolated from various types of 9 643 specimens ,and the detection rate was 1 .79% .There were statistical differences among detection rates in differ‐ent years and in different specimens (P<0 .01) .Pathogenic serotypes O∶3 and O∶9 carried ail gene and ystA gene were de‐tected from specimens of pigs and diarrhea patient .Non‐pathogenic serotypes O∶5 and O∶8 and non‐typeable strains didn't carry ail gene and ystA gene ,and also can't be detected from swine ,cattle ,sheep ,chickens and dogs .In conclusion ,Y .en‐terocolitica was widely distributed in Ningxia and pigs were the dominant animal host .In all pathogenic serotypes ,the highest proportion was O∶3 following by O∶9 .It was no time and regional difference in the distribution of that in Ningxia ,China .

Objective: To explore the structural domains of the CENP-E protein that interact with Mps1 protein.Methods: Two recombinant vectors named pEGFP-CENPE2(containing 674-1085 amino acids of CENP-E protein) and pEGFP-CENPE 3(containing 1200~2134 amino acids of CENP-E protein) were transfected into human embryo kidney 293(HEK293) cells respectively.The respective energy transfer efficiency(Ef) between either EGFP-CENPE2 and Mps1,or EGFP-CENPE3 and Mps1 were detected by FRET through selective photobleaching of the acceptors.Results: Both recombinant proteins expressed in HEK293 cells transfected by the recombinant plasmids were found to co-localize with the Mps1 protein as confirmed by confocal microscopy.The Ef between EGFP-CENPE3 and Mps1 protein was [(12.63?0.48)%,n=30] and that between EGFP-CENPE3 and Mps1 protein was [(3.17?0.21)%,n=30] as revealed by the results from FRET,the result of FRET was confirmed by co-Immunoprecipitate(CO-IP) method.When compared with that between the control and Mps1,the Ef between EGFP-CENPE3 and Mps1 was significantly higher(p